Tobacco and Spine Health
Most patients are aware of the detrimental effects of smoking, which can result in lung disease, heart disease and stroke. However, most are unaware of the long-term consequences of tobacco on spine health.Tobacco products, including snuff and e-cigarettes, contain nicotine. Long-term exposure to nicotine can result in the development of atherosclerosis, which involves the narrowing of vessels. This can include the narrowing of the cardiac vessels (coronary artery disease), vessels leading to the brain (can result in stroke) or vessels in the legs (peripheral vascular disease), all resulting in reduced delivery of oxygen and vital nutrients to these organs.Recently the surgeon general added diabetes, rheumatoid arthritis, and erectile dysfunction to the list of diseases caused by smoking. Nicotine use can also result in reduced blood flow to the spine, and more importantly, reduce blood supply to the discs that help cushion the vertebrae in the spine. The discs have a tenuous blood supply, and with chronic nicotine exposure, can degenerate, resulting in multiple problems in the spine including degenerative disc disease and various other related conditions. Smokers are also more likely to develop an earlier onset of back and neck pain, reduced daily functionality and arthritis of other areas as well, including hips and knees. The risks of developing degenerative arthritis of the spine is cumulative and is dependent on the smoking intensity (packs per day) and duration of tobacco use. New research demonstrates that discontinuing tobacco use can result in pain improvement in patients with spinal disorders, especially those that experience back/neck pain and sciatica like pain. This was seen in the young and with older patients with pain. Additionally, patients undergoing spinal surgery, such as spinal fusion, encountered a successful fusion if they quit smoking prior to surgery. If not, there is a higher risk of requiring re-operation. Aside from the direct effect of tobacco on the spine, smoking has been shown to be associated with higher rates of lung and heart complications after anesthesia, longer hospital stays, more admissions to the intensive care unit and prolonged recovery periods after any operation. If you are currently smoking, I encourage you to talk to your doctor about the various resources to assist you with quitting. Dr. Riz Saldin practices pain medicine at Piedmont Orthopaedic Complex, offering patients conservative and non-surgical options for pain relief. Dr. Saldin is board certified in both neurology and interventional pain medicine, and he uses his competitive background to both expertly identify, target and effectively treat the exact source of pain.
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